Mei Ling Yap

Expanding global access to radiotherapy

Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US

Stereotactic Body Radiotherapy in Patients with Previous Pneumonectomy: Safety and Efficacy

26·6 billion in low-income countries,

Global Access to Radiotherapy Services: Have We Made Progress During the Past Decade?

62·6 billion in lower-middle-income countries, and

The Role of Elective Para-aortic Lymph Node Irradiation in Patients with Locally Advanced Cervical Cancer

94·8 billion in upper-middle-income countries, which amounts to

Australian survey on current practices for breast radiotherapy

184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower:

Interrater Reliability of the Categorization of Late Radiographic Changes After Lung Stereotactic Body Radiation Therapy

14·1 billion in low-income,

MRI geometric distortion: Impact on tangential whole-breast IMRT

33·3 billion in lower-middle-income, and

Global Health in Radiation Oncology: The Emergence of a New Career Pathway

49·4 billion in upper-middle-income countries-a total of

Hypofractionated versus conventionally fractionated radiotherapy for ductal carcinoma in situ (DCIS) of the breast

96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of

Outcomes following treatment for patients with cranial nerve involvement from nasopharyngeal cancer

278·1 billion in 2015-35 (